Abstract:
OBJECTIVE:To determine the outcome of administration of neuroleptics to patients with senile dementia of Lewy body type confirmed at necropsy. DESIGN:Retrospective analysis of clinical notes blind to neuropathological diagnosis. SETTING:Specialist psychogeriatric assessment units referring cases for necropsy to a teaching hospital neuropathology service. PATIENTS:41 elderly patients with diagnosis of either Alzheimer type dementia (n = 21) or Lewy body type dementia (n = 20) confirmed at necropsy. MAIN OUTCOME MEASURES:Clinical state including extrapyramidal features before and after neuroleptic treatment and survival analysis of patients showing severe neuroleptic sensitivity compared with the remainder in the group. RESULTS:16 (80%) patients with Lewy body type dementia received neuroleptics, 13 (81%) of whom reacted adversely; in seven (54%) the reactions were severe. Survival analysis showed an increased mortality in the year after presentation to psychiatric services compared with patients with mild or no neuroleptic sensitivity (hazard ratio 2.70 (95% confidence interval 2.50-8.99); (chi 2 = 2.68, p = 0.05). By contrast, only one (7%) of 14 patients with Alzheimer type dementia given neuroleptics showed severe neuroleptic sensitivity. CONCLUSIONS:Severe, and often fatal, neuroleptic sensitivity may occur in elderly patients with confusion, dementia, or behavioural disturbance. Its occurrence may indicate senile dementia of Lewy body type and this feature has been included in clinical diagnostic criteria for this type of dementia.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
McKeith I,Fairbairn A,Perry R,Thompson P,Perry Edoi
10.1136/bmj.305.6855.673keywords:
subject
Has Abstractpub_date
1992-09-19 00:00:00pages
673-8issue
6855eissn
0959-8138issn
1756-1833journal_volume
305pub_type
杂志文章abstract:OBJECTIVES:To compare the course and outcome of psychotic illness in a group of Afro-Caribbean patients resident in the United Kingdom and a group of white British patients. DESIGN:Cohort study of consecutive admissions followed up for four years. SUBJECTS:113 patients with psychotic illness of recent onset admitted ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.311.7016.1325
更新日期:1995-11-18 00:00:00
abstract:OBJECTIVE:To confirm the findings of pilot studies that interferon alfa is an effective treatment of Europid men with chronic hepatitis B virus infection. DESIGN:Randomised controlled trial of three months treatment with interferon alfa followed by 12 months of observation. SETTING:Outpatient clinic of a tertiary ref...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.299.6700.652
更新日期:1989-09-09 00:00:00
abstract:OBJECTIVES:To develop a systematic method for both summative and formative audit of practice audits, and to use the method to review Oxfordshire practice audits and to plan improvement. DESIGN:Development of a coding system for the audit cycle subsequently used prospectively to assess audits reported to medical audit ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析
doi:10.1136/bmj.303.6812.1247
更新日期:1991-11-16 00:00:00
abstract:PROBLEM:Zimbabwe has one of the highest rates of HIV seroprevalence in the world. In 2001 only 4% of women and children in need of services for prevention of mother to child transmission of HIV were receiving them. DESIGN:Pilot implementation of the first programme for prevention of mother to child transmission of HIV...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.329.7475.1147
更新日期:2004-11-13 00:00:00
abstract:OBJECTIVE:To determine whether use of intermediate acting neuromuscular blocking agents during general anesthesia increases the incidence of postoperative respiratory complications. DESIGN:Prospective, propensity score matched cohort study. SETTING:General teaching hospital in Boston, Massachusetts, United States, 20...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e6329
更新日期:2012-10-15 00:00:00
abstract:OBJECTIVE: To determine whether the treatment effect of apixaban versus warfarin differs with increasing numbers of concomitant drugs used by patients with atrial fibrillation. DESIGN: Post hoc analysis performed in 2015 of results from ARISTOTLE (apixaban for reduction in stroke and other thromboembolic events in atr...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.i2868
更新日期:2016-06-15 00:00:00
abstract:OBJECTIVE:To compare the effectiveness of beta lactam monotherapy versus beta lactam-aminoglycoside combination therapy in the treatment of patients with fever and neutropenia. DATA SOURCES:Medline, Embase, Lilacs, the Cochrane Library, and conference proceedings to 2002. References of included studies and contact wit...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.326.7399.1111
更新日期:2003-05-24 00:00:00
abstract:OBJECTIVES:To gain insight into people's thoughts on stroke and to inform the development of educational strategies in the community. DESIGN:Focus group discussions: two groups of people who had a stroke and their carers, and two groups of members of the general public. SETTING:New South Wales, Australia. PARTICIPAN...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.324.7345.1065
更新日期:2002-05-04 00:00:00
abstract:OBJECTIVE:To explore geographical and sociodemographic factors associated with variation in equity in access to total hip and knee replacement surgery. DESIGN:Combining small area estimates of need and provision to explore equity in access to care. SETTING:English census wards. SUBJECTS:Patients throughout England w...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.c4092
更新日期:2010-08-11 00:00:00
abstract:OBJECTIVE:To compare the efficacy of surgery with disc prosthesis versus non-surgical treatment for patients with chronic low back pain. DESIGN:A prospective randomised multicentre study. SETTING:Five university hospitals in Norway. PARTICIPANTS:173 patients with a history of low back pain for at least one year, Osw...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.d2786
更新日期:2011-05-19 00:00:00
abstract::The import of the HIV or AIDS epidemic for heterosexuals in Britain is difficult to evaluate at this stage. By June 1988, only 60 cases of heterosexually acquired AIDS are known, out of 1598 reported AIDS cases. Of these, only 6 women and 4 men presumably were infected in Britain, the rest abroad. But, judging from...
journal_title:BMJ (Clinical research ed.)
pub_type: 社论
doi:10.1136/bmj.298.6671.401
更新日期:1989-02-18 00:00:00
abstract:OBJECTIVES:To investigate patients' and family members' perceptions and experiences of disclosure of healthcare incidents and to derive principles of effective disclosure. DESIGN:Retrospective qualitative study based on 100 semi-structured, in depth interviews with patients and family members. SETTING:Nationwide mult...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.d4423
更新日期:2011-07-25 00:00:00
abstract:OBJECTIVE:To describe the characteristics at birth of children conceived by in vitro fertilisation (IVF) or by gamete intrafallopian transfer (GIFT) and to assess whether they differ from those of children conceived naturally. DESIGN:Survey of children resulting from IVF or GIFT and comparison of their characteristics...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.300.6734.1229
更新日期:1990-05-12 00:00:00
abstract:OBJECTIVE:To characterise the functional morphology of the nasal microcirculation in humans in comparison with reindeer as a means of testing the hypothesis that the luminous red nose of Rudolph, one of the most well known reindeer pulling Santa Claus's sleigh, is due to the presence of a highly dense and rich nasal mi...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e8311
更新日期:2012-12-14 00:00:00
abstract:OBJECTIVE:To investigate the psychosocial factors associated with consultation for low back pain. DESIGN:Two phase cross sectional postal survey. SETTING:Bradford Metropolitan Health District. SUBJECTS:1813 adults responding to the phase 1 questionnaire. 540 of the 782 with an episode of low back pain in the past 12...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.317.7172.1564
更新日期:1998-12-05 00:00:00
abstract:OBJECTIVE:To estimate the risk of acute myocardial infarction (AMI) or stroke in adults with non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH). DESIGN:Matched cohort study. SETTING:Population based, electronic primary healthcare databases before 31 December 2015 from four European coun...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.l5367
更新日期:2019-10-08 00:00:00
abstract:OBJECTIVE:To assess long term survival (> 5 years) and quality of life in severely ill patients referred for urgent cardiac transplantation. SETTING:Tertiary referral centres: before transplantation at the National Heart Hospital (late 1984 to end 1986); after transplantation at Harefield Hospital. SUBJECTS:Eighteen ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6870.98
更新日期:1993-01-09 00:00:00
abstract:OBJECTIVE:To examine the hypothesis that risk of oesophageal, but not of gastric or colorectal, cancer is increased in users of oral bisphosphonates. DESIGN:Nested case-control analysis within a primary care cohort of about 6 million people in the UK, with prospectively recorded information on prescribing of bisphosph...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.c4444
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:To examine whether there are too many hospital beds in London. DESIGN:Analysis of data from the Hospital In-Patient Enquiry, Mental Health Enquiry, health service indicators, and Emergency Bed Service. SETTING:England, London, and inner London. RESULTS:Hospital admission rates for acute plus geriatric serv...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6883.979
更新日期:1993-04-10 00:00:00
abstract:STUDY QUESTION:What are the long term trends in the total (live births, fetal deaths, and terminations of pregnancy for fetal anomaly) and live birth prevalence of neural tube defects (NTD) in Europe, where many countries have issued recommendations for folic acid supplementation but a policy for mandatory folic acid f...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.h5949
更新日期:2015-11-24 00:00:00
abstract:OBJECTIVES:To assess whether supplementation with antioxidants, folinic acid, or both improves the psychomotor and language development of children with Down's syndrome. DESIGN:Randomised controlled trial with two by two factorial design. SETTING:Children living in the Midlands, Greater London, and the south west of ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.39465.544028.AE
更新日期:2008-03-15 00:00:00
abstract:OBJECTIVE:To conduct a systematic review and meta-analysis of cohort studies of body mass index (BMI) and the risk of all cause mortality, and to clarify the shape and the nadir of the dose-response curve, and the influence on the results of confounding from smoking, weight loss associated with disease, and preclinical...
journal_title:BMJ (Clinical research ed.)
pub_type: 评论,杂志文章
doi:10.1136/bmj.i2156
更新日期:2016-05-04 00:00:00
abstract:OBJECTIVES:To relate cancer since entry into the Framingham Heart Study with the risk of incident Alzheimer's disease and to estimate the risk of incident cancer among participants with and without Alzheimer's disease. DESIGN:Community based prospective cohort study; nested age and sex matched case-control study. SET...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e1442
更新日期:2012-03-12 00:00:00
abstract:OBJECTIVE:To determine the effect of four monthly vitamin D supplementation on the rate of fractures in men and women aged 65 years and over living in the community. DESIGN:Randomised double blind controlled trial of 100 000 IU oral vitamin D3 (cholecalciferol) supplementation or matching placebo every four months ove...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.326.7387.469
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:To assess the risk of adverse perinatal events of vaccination of pregnant women with an MF59 adjuvanted vaccine. DESIGN:Cross sectional multicentre study. SETTING:49 public hospitals in major cities in Argentina, from September 2010 to May 2011. PARTICIPANTS:30,448 mothers (7293 vaccinated) and their 30,76...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究
doi:10.1136/bmj.f393
更新日期:2013-02-04 00:00:00
abstract:OBJECTIVE:This study updates work published in 1998, which found that of 47 rating instruments appearing on websites offering health information, 14 described how they were developed, five provided instructions for use, and none reported the interobserver reliability and construct validity of the measurements. DESIGN:...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.324.7337.569
更新日期:2002-03-09 00:00:00
abstract:OBJECTIVE:To investigate the intrinsic effects of individually prescribed homoeopathic medicines. DESIGN:Randomised double blind placebo controlled study. SETTING:Paediatric outpatient department of university hospital. PATIENTS:175 children with frequently recurring upper respiratory tract infections. Of the 170 ch...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.309.6965.1329
更新日期:1994-11-19 00:00:00
abstract:OBJECTIVE:To determine whether a decision aid designed for adults with low education and literacy can support informed choice and involvement in decisions about screening for bowel cancer. DESIGN:Randomised controlled trial. SETTING:Areas in New South Wales, Australia identified as socioeconomically disadvantaged (lo...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.c5370
更新日期:2010-10-26 00:00:00
abstract:OBJECTIVE:To prepare and assess the sensitivity and specificity of a latex agglutination test specific for the serotype of antigen in diagnosing pneumococcal pneumonia in Gambian children. DESIGN:Comparison of agglutination test specific for serotype with culture of blood and lung aspirates, countercurrent immunoelect...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章
doi:10.1136/bmj.298.6680.1061
更新日期:1989-04-22 00:00:00
abstract:OBJECTIVES:To investigate the circumstances since the 1950s in which people who were attracted to members of the same sex received treatments to change their sexual orientation, the referral pathway and the process of therapy, and its aftermath. DESIGN:A nationwide study based on qualitative interviews. PARTICIPANTS:...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.37984.442419.EE
更新日期:2004-02-21 00:00:00